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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES �3--a � 05 <br />3200 CEDAR STREET, EVERETT, WA 98201 C p rj D��►S7 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTEU <br />� � ,� �7 <br />�• ��j % /j C.V-s �-�� /S ! � � /�n i� ,i7 <br />PROJECT ADDRESS <br />Tenant <br />OL�O r' T/: � � <br />Elecirical CoNradcr <br />Sta�e License Number <br />Proposed Use of Buildin9 <br />��� �"�i ; <br />' Address <br />Mail Address <br />.� <br />Cily <br />City <br />Ciry <br />Stale/Zip <br />Slale2ip <br />State/Zip <br />Contract Price of Work <br />Conlact Person (Plan Review) <br />Phone <br />Phona <br />Phone <br />Uescriplion o( Work lo Be Dnnr.: /.f�� r v /� r�-�-' �' a/� �� `• — <br />NOTE: WIRING IN NON•DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1lie�eby r,erfily thnt I ha��e read and exantined fhis applicafion and knaw fhe same to bo true and <br />conecL All p�ovisions olla�vs and ordinances governmy fhis type ol work will be complefed <br />whelher specilied he�ein or noL The granting ol a pemul does nof �resume to �ive authonty fo <br />violafe or cancel fhe provisions ol any efher sfafe or(ocallaw rec�u�afing consfruc6on or fhe <br />pr,�lormance o/consfruc(ion. That 1 am aufhorized by fhe owner ol fhis p�operty to perlonn fhe <br />��ork lor whir.h applicafion is rnade and � comply wifh the Sfafe Conhacfors Law id27 RCW and <br />29& 200 WFC. <br />� -' <br />FEE <br />i= `� c� �-5� <br />�- <br />